Website for anemia

[robe25]

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I am wondering if anyone knows a website or program where I can get a good differential for anemia, by plugging in the right indicies. Ie put in MCV, Fe, transferrin etc get told my pt has a thalassemia.

 

[BlackNDecker]

You mean you want someone else to make the diagnosis for you?

Heme is easy...it takes some hard work on your part initially to get the indices memorized. But, once you understand why the indices move in the direction they do, you'll be able to tackle much more complex problems logically. Plus you're gonna get dominated on rounds (as you should) if you can't decipher common iron panels...

More specifically on thalassemia...You can't diagnose thalassemia soley on iron indices (YOU NEED TO UNDERSTAND WHY). The least expensive test is a trial of iron and a repeated hemogram a month later. To make the specific diagnosis you'll need to do hemoglobin electrophoresis.

 

[Blade28]

It's probably easier to understand the concepts than to search for such a website.

You're going to find MANY similar situations - endocrine (especially CRH/ACTH/cortisol, or GNRH/LH/FSH, or TSH/T3/T4, etc.) is rife with these.

Just try and learn them systematically.

 

[mjl1717]

Thalassemia produces a greater level of microcytosis for any given level of anemia than does iron deficiency.. RBC morphology on a smear is more likely to be abnormal earlier in the course of thalassemia.. Also thalassemia is more likely to have a normal RBC count..

 

[BlackNDecker]

Also thalassemia is more likely to have a normal RBC count..

Thalassemias will also often show a characteristic elevation in the RBC count due to massive extramedullary erythropoiesis. The increased RBC count is trying to compensate for diminished Hb synthesis and the resulting hypoxia (causing increased epoietin synthesis).

 

[mjl1717]

Thalassemias will also often show a characteristic elevation in the RBC count due to massive extramedullary erythropoiesis. The increased RBC count is trying to compensate for diminished Hb synthesis and the resulting hypoxia (causing increased epoietin synthesis).

I should have added thalassemia compared to iron deficiency anemia is more likely to have a normal RBC count..

 

[shivasHeroLike]

i agree with what someone said earlier, organize it systematically.

i like to start by organizing them by there MCVs to form 3 groups...

microcytic, nomocytic, and macrocytics

within normocytic i organize by reticulocyte counts (to see whether its a bone marrow problem or mature RBCs)

within mature RBCs you can break it down by enzyme deficiencies, hemoglobin, and maybe like 3-4 other problems..

follow?

 

[KECKington]

I should have added thalassemia compared to iron deficiency anemia is more likely to have a normal RBC count..

Also thalasemia is due to genes so the RDW is normal and for Fe deficiency the RDW is elevated as it varies depending on your FE intake/ (deficiency) varies.